Oral airway

ABSTRACT

An oral airway for providing an air passage to a patient&#39;s trachea. The oral airway includes a curved section and a straight section with the curved section having spaced-apart curved upper and lower members and the straight section having spaced-apart planar upper and lower members with the same width. The curved upper member has the same width as the planar upper member with the curved lower member having a greater width than the width of the lower planar member. The width of the curved lower member is greater than the width of the planar lower member and the distance between the curved upper and lower members is greater than the distance between the planar upper and lower members. The curved lower member has a generally inverted V-shaped cross-section.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to an oral airway and more particularly to anoral airway which truly represents an improvement in the oral airwayart.

2. Description of the Related Art

In modern anesthesia practice, oral airways are used primarily for tworeasons. The first reason is that after intubation of the trachea, anoral airway is placed to prevent a patient from biting down on theendotracheal tube and thus occluding the endotracheal tube. The secondand primary reason for the use of an oral airway in the practice ofaesthesia is to elevate the tongue against the floor of the mouth tocreate a larger opening in the mouth to facilitate the utilization ofpositive pressure ventilation using an anesthesia mask after a patienthas been given medications to induce general anesthesia. The drugsnormally used to induce general anesthesia may greatly decrease oraltogether stop the patient's own spontaneous respiratory effort.Therefore, the Anesthesia Practitioner must immediately begin assistingor controlling the patient's ventilation.

It has been noted that patients undergoing general anesthesia haveoccasional difficulties in maintaining the a patient's airway and theability to ventilate the patient. It has been observed that patients ofall ages which were difficult to ventilate with an anesthesia mask afterinduction of general anesthesia. This has happened even after properplacement of the recommended size of oral airway. Anyone who haspracticed anesthesia for some time has experienced the samedifficulties. Anesthesia Practitioners are all taught the “tricks of thetrade” in how to ventilate patients after induction of generalanesthesia including a variety of physical adjustments to theanesthetized patient such as elevation of the jaw and extension of thepatient's neck. If the patient cannot be adequately ventilated afterinduction of general anesthesia, life-threatening problems may developsuch as hypoxia, hypercarbia, cardiac arrhythmias and even death.

Once general anesthesia has been induced, one of the main impediments toadequately ventilating a patient with positive pressure ventilation,after placement of an oral airway, is the relaxation of the soft tissuestructures in the hypo-pharynx. These structures tend to collapse, thusobstructing airflow. This inward collapsing occurs both front to backand side to side, thus greatly decreasing the size of the oral openingthrough which the Anesthesia Practitioner may ventilate the patient.This anatomical relaxation is fairly consistent with every patient whoundergoes a general anesthetic. However, there is a physicalcharacteristic of some patients which greatly increases the difficultyof mask ventilation—that characteristic is obesity. Applicant has notedthe increasing incidence of obesity in both the pediatric and adultpopulation. These obese patients present an increased level ofdifficulty to the Anesthesia Practitioner in the area of airwaymanagement. Obese patients tend to have larger, thicker tongues alongwith more redundant soft tissue in the oropharyngeal area. Obesepatients also tend to have thicker necks, so it is more difficult tohyperextend the neck and lift the jaw to facilitate adequate ventilationafter general anesthesia is induced. In discussions with otherAnesthesia Practitioners, the inventor has perceived a common concernthat the oral airways currently available do not adequately address thegrowing problem of obesity in the population.

As stated, it is well known to utilize an oral airway for the purpose ofaiding the breathing of unconscious patients. Reference may be made toU.S. Pat. No. 2,599,521, which issued Jun. 3^(rd), 1952, to R. A.Berman, for a description of a conventional oral airway now known inmedical practice as the Berman Oral Airway. The Berman Oral Airway, andlater devices modeled after it, is employed in the practice ofanesthesia and other areas of respiratory medicine by insertion of theoral airway into the mouth and pharynx of a patient to provide a channelfor respiratory purposes, particularly in unconscious patients such asthose who have been administered a general anesthetic. It is the purposeof the oral airway to prevent respiratory obstruction by preventingcollapse of the pharyngeal tissues and/or obstruction of the pharynx bythe tongue.

The Berman Oral Airway and later devices are available to the medicalprofessional in a number of different sizes for use in all sizes ofpatients from premature infants to large adults. However, each sizeconstitutes a unitary member which may not itself be adjusted in size,shape, or contour. Thus, conventional airways are substantially rigidstructures which may not be altered in use to fit particular patients,particular problems, or unusual anatomic anomalies or structures. TheBerman Oral Airway has served Anesthesia Practitioners well for manyyears, but the physical characteristics of patients have changed since1952 while the Berman Oral Airway remains the same.

The Berman Oral Airway comes in various sizes from 40 mm to 100 mm inincremental steps of 10 mm (i.e., 40 mm, 50 mm, 60 mm, 70 mm, 80 mm, 90mm, and 100 mm). These sizes are roughly correlated to general anatomicdimension described as the distance from the exterior of the front teethto the back of the oropharynx. So, correspondingly, a 40 mm Berman OralAirway is probably an appropriate size for a premature infant whereas a100 mm Berman Oral Airway is probably appropriate for a large adult, anda 90 mm Berman Oral Airway is generally used on a medium adult patient.If the patient is very obese and has a thick tongue and has a largeamount of soft tissue in the oropharynx, the 90 mm oral airway may notadequately elevate the tongue because it is not wide enough side to sideto provide enough support for the tongue. In this case, a 100 mm BermanOral Airway (which is wider side to side) may provide the additionalsupport for the tongue that is needed to open the airway, but it cannotbe used because the longer structure of the airway (100 mm) may not fitin the patient's mouth. The 100 mm oral airway would extend too faroutside of the patient's mouth, thus placing an anesthesia mask over thepatient's face to obtain a good mask seal in order to ventilate thepatient with positive pressure would be very difficult, if notimpossible. The usual scenario is someone who is of very short statureand very obese. These people many times need the width and depth of a100 mm Berman Oral Airway, but the length of an 80 mm Berman OralAirway. This would greatly facilitate the ability to ventilate thispatient after induction of general anesthesia. This problem has beenovercome in the past by actually inserting two 80 mm Berman Oral Airwayson these types of patients or sometimes one 90 mm Berman Oral Airway andone 80 mm Berman Oral Airway. In this way you are able to achieve enoughside to side tongue support to adequately ventilate the patient untilyou are ready to place an LMA or intubate the patient. Inserting twoairways into the patient is sometimes adequate but can be awkward.Therefore, a new type of airway is needed for these patients.

SUMMARY OF THE INVENTION—THE BUTTERFLY ORAL AIRWAY

Accordingly, the present invention provides modifications to the BermanOral Airway which will provide better elevation of the tongue againstthe floor of the mouth by way of: 1) a longer middle support distancewhich increases the distance the tongue is elevated against the floor ofthe mouth thus increasing the anterior-posterior dimension of the airwayopening; 2) the greater width of the curved lower member of the curvedsection of the oral airway which will give better support to the tonguelaterally, thus increasing the side to side dimension of the airwayopening; and 3) the elevation of the lower curved member of the curvedsection of the airway into an inverted “V” shape which will also greatlyincrease the lateral support of the tongue.

By altering these three characteristics of the Berman Oral Airway, butnot altering the length or the radius of the curve of the airway, theinstant airway sizes would be interchangeable with the Berman OralAirway sizes. For instance, in a situation where you would normally usean 80 mm Berman Oral Airway, the 80 mm airway of this invention would beappropriate, but would give better tongue support and consequently alarger opening of the patient's airway to facilitate easier ventilationof the patient. This would be especially helpful in obese patients withlarge tongues, but would also be useful for all patients beingadministered general anesthesia.

More particularly, the oral airway of this invention comprises astraight section having inner and outer ends adapted to fit between thepatient's teeth and a curved section adapted to fit over the patient'stongue and extending to the oropharyngeal area. The straight section ofthe oral airway includes a substantially planar upper member and asubstantially planar lower member which are spaced-apart by a medial webextending therebetween. The planar upper and lower members of thestraight section have substantially the same widths. The outer end ofthe planar upper member has a flange extending upwardly therefrom andthe outer end of the planar lower member has a flange extendingdownwardly therefrom. The flanges externally overlie the lips of thepatient. The curved section of the airway comprises spaced-apart curvedupper and lower members which are spaced-apart by a medial web extendingtherebetween. The curved upper member of the curved section hassubstantially the same width as the planar upper member of the straightsection. The curved lower member of the curved section has a generallyinverted V-shaped cross-section and has a greater width forsubstantially its entire length than the planar lower member of thestraight section. In the preferred embodiment of the oral airwaydescribed above, the distance between the curved upper and lower membersof the curved section, at either side of the medial web, is greater thanthe distance between the planar upper and lower members of the straightsection for substantially the entire length thereof. The oral airway ofthis invention may be either a 100 mm, 90 mm, 80 mm, 70 mm, 60 mm, 50mm, or 40 mm size.

It is therefore a principal object of the invention to provide animproved oral airway to provide an air passage to the patient's trachea.

A further object of the invention is to provide an improved oral airwaywhich will provide better elevation of the tongue against the floor ofthe mouth by way of: 1) a longer middle support distance which increasesthe distance the tongue is elevated against the floor of the mouth, thusincreasing the anterior-posterior dimension of the airway opening; 2)the greater width of the curved lower member of the curved section ofthe oral airway which will give better support to the tongue laterally,thereby increasing the side to side dimension of the airway opening; and3) the elevation of the lower curved member of the curved section of theairway into an inverted “V” shape which will also greatly increase thelateral support of the tongue.

These and other objects will be apparent to those skilled in the art.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a bottom perspective view of the oral airway of thisinvention;

FIG. 2 is a side sectional view of the oral airway of this inventioninserted into the patient's mouth;

FIG. 3 is a bottom elevational view of the airway of FIG. 1;

FIG. 4 is a top view of the oral airway of FIG. 1;

FIG. 5 is a side view of the oral airway of FIG. 1;

FIG. 6 is a sectional view as seen on lines 6-6 of FIG. 5; and

FIG. 7 is a sectional view as seen on lines 7-7 of FIG. 5.

DETAILED DESCRIPTION OF THE INVENTION

In the drawings, the numeral 12 refers generally to the preferredembodiment of this invention. Airway 12 includes a straight section 14having an upper planar member 16 and a lower planar member 18 which arespaced-apart by means of a medial web or rib 20. Flange 22 extendsupwardly from the outer end of planar upper member 16 while flange 24extends downwardly from the outer end of planar lower member 18. Theflanges 22 and 24 externally overlie the lips of the patient asillustrated generally in FIG. 2.

Airway 12 also includes a curved section 26 which is comprised of acurved upper member 28 and a curved lower member 30 which arespaced-apart by a continuation of the medial web 20 and which isdesignated by the reference numeral 20A. As seen, the curved lowermember 30 has a generally inverted “V” shape. The width of upper member28 is substantially the same as the width of the planar upper member 16.The width of the inverted V-shaped curved lower member 30 is greaterthan the width of planar lower member 18. In the preferred embodiment,the members 28 and 30, at their juncture with the medial web 20A, arespaced-apart at a greater distance than the distance between members 16and 18. However, due to the inverted “V” shape of member 30, there aresome situations where the member 28 and 30, at their juncture with themedial web 20A, are spaced-apart the same distance as the members 16 and18.

FIG. 6 illustrates a cross-sectional view of the straight section 14 ofthe oral airway 12 wherein it can be seen that the width W₁ of theflange 24 is less than the width of the member 30. FIG. 6 alsoillustrates as T₁ the distance or spacing between members 16 and 18 ofstraight section 14.

As seen in FIG. 7, the width of member 30 (W₂) is greater than the widthof member 28 (W₁) and that the distance between members 28 and 30 attheir juncture with the medial web 20A is greater than the distance T₁between member 16 and 18. FIG. 7 also illustrates that the sides 32 and34 of member 30 are disposed at an angle A to provide the inverted “V”shape of member 30.

Therefore, the present invention provides modifications to the BermanOral Airway which will provide better elevation to the tongue againstthe floor of the mouth by way of: 1) a longer middle support distancewhich increases the distance the tongue is elevated against the floor ofthe mouth thus increasing the anterior-posterior dimension of the airwayopening; 2) the greater width of the lower member 30 which will givebetter support to the tongue laterally, thus increasing the side to sidedimension of the airway opening; and (3) the elevation of the lowercurved member of the curved section of the airway into an inverted “V”shape which will also greatly increase the lateral support of thetongue.

By altering the three dimensions of the Berman Oral Airway, but notaltering the length or the radius of the curve of the airway, the sizeof the oral airway of this invention would be interchangeable with theBerman Oral Airway sizes. For instance, in a situation wherein a personwould normally use an 80 mm Berman Oral Airway, the 80 mm airway of thisinvention would be appropriate, but would give better tongue support andconsequently a larger opening of the patient's airway to facilitateeasier ventilation of the patient. This would be especially helpful inobese patients with large tongues, but would also be useful for allpatients being administered general anesthesia.

Thus it can be seen that the invention accomplishes at least all of itsstated objectives.

1. An oral airway to provide an air passage to a patient's trachea,comprising: a straight section having inner and outer ends adapted tofit between the patient's teeth; a curved section adapted to fit overthe patient's tongue and extending to the oropharyngeal area; saidstraight section including a substantially planar upper member and asubstantially planar lower member which are spaced-apart by a medial webextending therebetween; said planar upper and lower members of saidstraight section having substantially the same widths; said outer end ofsaid planar upper member having an upwardly extending flange; said outerend of said planar lower member having a downwardly extending flange;said flanges adapted to be externally overlying the lips of the patient;said curved section comprising spaced-apart curved upper and lowermembers which are spaced-apart by a medial web extending therebetween;said curved lower member having substantially the same width for itsentire length; said curved upper member of said curved section havingsubstantially the same width as said planar upper member of saidstraight section; said curved lower member of said curved section havinga greater width for substantially its entire length than said planarlower member of said straight section and said curved upper member; saidcurved lower member of said curved section having a generally invertedV-shaped cross-section; each of said curved lower member and said curvedupper member of said curved section having side edges; the distancebetween the side edges of said curved lower member and said curved uppermember of said curved section being greater than the distance betweenthe side edges of said planar upper and lower members of said straightsection; the distance between the side edges of said curved lower memberand said curved upper member of said curved section being substantiallyconstant for substantially the entire length of said curved section. 2.An oral airway to provide an air passage to a patient's trachea,comprising: a straight section having inner and outer ends adapted tofit between the patient's teeth; a curved section adapted to fit overthe patient's tongue and extending to the oropharyngeal area; saidstraight section including a substantially planar upper member and asubstantially planar lower member which are spaced-apart by a medial webextending therebetween; said planar upper and lower members of saidstraight section having substantially the same widths; said outer end ofsaid planar upper member having an upwardly extending flange; said outerend of said planar lower member having a downwardly extending flange;said flanges adapted to be externally overlying the lips of the patient;said curved section comprising spaced-apart curved upper and lowermembers which are spaced-apart by a medial web extending therebetween;said curved lower member having substantially the same width for itsentire length; said curved upper member of said curved section havingsubstantially the same width as said planar upper member of saidstraight section; said curved lower member of said curved section havinga greater width for substantially its entire length than said planarlower member of said straight section and said curved upper member; saidcurved lower member of said curved section having a generally invertedV-shaped cross-section; each of said curved lower member and said curvedupper member of said curved section having side edges; the distancebetween the side edges of said curved lower member and said curved uppermember of said curved section being greater than the distance betweenthe side edges of said planar upper and lower members of said straightsection; the distance between the side edges of said curved lower memberand said curved upper member of said curved section being constant forsubstantially the entire length of said curved section.